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Objective:To analyze the expression level of malignant biological marker gene in locally advanced low rectal cancer tissues after neoadjuvant chemotherapy with XELOX, so as to provide guidance for clinical treatment.Methods:Based on the established inclusion and exclusion criteria, 104 patients with locally advanced low rectal cancer treated in the Surgery Department of the Affiliate Hospital of Qingdao University from January 2017 to January 2018 were included in the study. Based on the random number table method, they were divided into observation group and control group, with 52 patients in each group. Radical resection was performed in both groups, while radical resection was performed directly in the control group, and neoadjuvant chemotherapy with XELOX plus radical resection was performed in the observation group. The effect of tumor resection in the two groups was compared and analyzed, and the expression levels of tumor markers and malignant biological marker genes in the tumor tissues after surgery were determined. The 3-year postoperative survival rate of the two groups was followed up.Results:The R0 resection rate was 96.15% in the observation group and 80.77% in the control group, with statistically significant difference ( P<0.05). There were no significant differences in the serum levels of cancer antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA) and carbohydrate antigen 50 (CA50) before the operation in the two groups ( P>0.05). One week after the operation, the serum levels of CA19-9, CEA and CA50 in the observation group were significantly lower than those in the control group ( P<0.05). Through detection, the relative mRNA expression levels of PPTG and Smad4 in the postoperative observation group were higher than those in the control group, while the relative mRNA expression levels of Runx3 and APC were lower than those in the control group, with statistically significant difference ( P<0.05). The 3-year follow-up survival rate in the observation group was 90.38%, significantly higher than 78.85% in the control group ( P<0.05). Conclusions:The application of XELOX neoadjuvant chemotherapy in radical resection of locally advanced low rectal cancer has important clinical value in reducing tumor malignancy, improving tumor resection effect and improving survival.
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Objective To discuss the experience of surgical treatment for cerebral sparganosis and analyze the factors affecting the removal of live worms.Methods A retrospective analysis was performed on clinical data and treatment experience of 49 patients with cerebral sparganosis,admitted to and accepted surgery in our hospital from January 2001 to December 2017.These patients were divided into two groups according to whether the live worms were removed during the operation,namely live worms removal group and live worms non-removal group;factors affecting the removal of live worms were analyzed.Results A total of 36 live worms were removed from 49 patients,one of them took out two live worms in the same lesion.In 45 patients with seizures before surgery,39 of them had seizure-flee after surgery (Engel grading I).Re-examination MR imaging showed that lesions disappeared and no new lesions were found in the brains of the 39 patients.Another two with original lesion enhancement had shadow disappearance;however,new lesions appeared behind the lesion;one of them was re-operated in the contralateral temporal lobe of the original lesion,and the other one continued follow-up observation.No new hemorrhage lesion,infarction or meningitis after operation was noted in all patients.Statistical analysis showed that there were significant differences in times from lesion discovery to surgery and lesion locations between patients of the live worms removal group and the live worms non-removal group (P＜0.05).Conclusions Surgical treatment of cerebral sparganosis is safe and effective.Surgical treatment should be performed as soon as possible after the lesion is discovered.The times from lesion discovery to operation should be shortened to prevent the displacement of the worms.At the same time,it is necessary to select the specific surgical plan and timing of surgery in combination with lesion location to improve removal rate of live insects and reduce surgical complications.If necessary,surgery can be performed again.
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OBJECTIVE:To observe clinical efficacy and safety of citalopram in the treatment of depression patients after lung cancer operation. METHODS:114 depression patients after lung cancer operation were selected and randomly divided into observa-tion group and control group (n=57). Control group was given routine treatment as nutrition support and electrolyte balance,but had no anti-depression drugs;observation group was given Citalopram tablet 20 mg orally,qd. Two groups were treated for 6 weeks. Clinical efficacy,HAMD and HAMA scores,each score and total score of SF-36 were observed before and after treatment. The occurrence of ADR was recorded. RESULTS:The total effective rate of observation group was 87.72%,which was significant-ly higher than that that of control group(71.93%),with statistical significance(P0.05);HAMA score and HAMD score of 2 groups decreased significantly after treatment,the observation group was lower than the control group;each score and total score of SF-36 increased significantly,the observation group was higher than the control group,with statistical sig-nificance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Citalopram is effective and safe for depression af-ter lung cancer operation,can improve mental state and quality of life.
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Objective To evaluate the efficacy of laparoscopic Miles surgery at differented periods.Methods Radical excision(Miles) was performed under a laparoscope on 33 patients from January 2002 to August 2002(group 1),and then on 34 cases from July 2006 to May 2007(group 2) in our hospital.Clinicopathological and follow-up data of the two groups were collected and analyzed.Results No significant difference was found in blood loss(50-200 ml vs 40-210 ml,Z=1.477,P=0.787),number of resected lymph nodes(both 3-5,Z=-0.089,P=0.233),gas expel(in 1-3 days after the surgery vs 1-4 days,Z=-1.622,P=0.574),and postoperative hospital stay(4-9 days vs 5-9 days,Z=-1.834,P=0.346) between the two groups.However,the patients in group 1 had significantly longer operation time and higher medical cost than group 2(175-210 min vs 120-150 min,Z=4.238,P=0.026;23400-27500 yuan vs 19863-22744 yuan,Z=5.283,P=0.003).Conclusion After 4-year development,the operation time and cost of laparoscopic Miles surgery has been decreased.